Eye Floaters and Flashes

What are Eye Floaters?

Eye floaters are reported as many different shapes and sizes. Most commonly, they are described as cobwebs, tiny black specs, or like clouds passing over the vision. Sometimes people feel they are seeing a bug flying around their vision, and even try to swat them! Other people see floaters as small circles or lines in their vision or feel that there is a hair in front of their eye. These floaters move when you move your eyes and will usually follow wherever you look. They also move across your vision when looking at a monochromatic background such as a white wall, blue sky, or a white sheet of paper.

Where do Eye Floaters come from?

Floaters actually come from inside the eye. In the back part of the eye, there is a structure called the vitreous gel, which liquefies over our lifetimes. As the gel in the eye breaks down and forms into clumps or disorganized strands, shadows of these fibers are projected on the retina, causing you to perceive a floater in your vision. While these floaters can be irritating, they are often harmless. They tend to be noticed while reading, or when you are looking at white backgrounds such as walls or the sky.

However, some flashes and floaters can let you know something is happening to your retina. You could be experiencing vitreous detachments or a detached retina, which must be diagnosed and treated.

What causes Eye Floaters?

As you age, the vitreous gel loses much of its strength and structure, so it will separate from the retina, a thin tissue lining the back wall of the eye. When the gel detaches from the retina, people often see one or more new floaters and/or flashing lights in their vision. The process of the gel pulling away from the back wall of the eye is called a posterior vitreous detachment. In most cases this process is age‑related, especially after age 50‑60.

In some cases, the retina may actually tear as the gel pulls away. A retinal tear needs to be detected and treated very quickly because it can lead to a retinal detachment, which may cause vision loss or even blindness. Other causes may include:

• Inflammation in the back of the eye
• Bleeding in the eye
• Prior eye surgery
• Eye medications
• Eye tumors
• Diabetic retinopathy

What are Eye Flashes?

As the vitreous gel pulls away from the back wall of the eye, you may develop new floaters and see flashes of lights in your eyes. Flashes of light may appear like a lightning streak or an arc of light. They may even appear similar to a camera flash. These eye flashes may persist for weeks to months.

Who is at risk?

Aging is a large risk factor for new eye floaters and flashes. People who are very nearsighted (high myopic prescriptions) are at greater risk of experiencing eye floaters or flashes at a younger age and can also be at greater risk for a retinal detachment or tear. Other risk factors may include: previous cataract surgery, eye trauma, diabetic retinopathy, or other complications.

What symptoms are reason to see a Doctor?

You should see your eye doctor as soon as possible if you experience:

• One or several new, large floaters or “showers” of floaters which appear suddenly
• Sudden flashes of light, especially if they persist
• Loss of your side/peripheral vision, as if a shade or curtain has been drawn over your field of vision

What is the treatment for Eye Floaters and Flashes?

Floaters and flashes will eventually fade with time and become less bothersome, but the length of time to resolution is different for each individual. Some floaters may remain long‑term. There is currently no treatment to remove all floaters completely.

While not all eye flashes and floaters are serious, you should always see your eye doctor for an eye exam if you have a new onset of symptoms to ensure there is no damage to your retina. If your doctor determines there has been damage to your retina, you will be referred to a retina specialist for laser treatment or surgery.